Long-term care insurance in Germany for expats

Moving to Germany long term might mean planning for older age – including what will happen if you need extra help to live independently. If you are trying to understand long term care insurance in Germany, Pflegeversicherung is the compulsory cover that helps with care costs if illness, disability, or age reduces a person’s ability to live alone without extra support.

Key takeaways

• Compulsory cover: Long-term care insurance is mandatory in Germany, often attached to your public or private health insurance.
• Link to health insurance: Statutory coverage generally follows your health insurer automatically; see Expatica’s guide to health insurance in Germany for details.
• Care grades: Benefits are determined by your approved Pflegegrad (care grade), so prepare for the assessment before applying.
• Partial cover: Statutory support helps with costs but is not full coverage; always request a written cost breakdown before selecting care.
• First step to claim: Contact your insurer or Pflegekasse (care fund) to start claims early, as benefits are typically not backdated.

If you think a claim may be needed, start with your insurer or care fund, not with a care home. Statutory cover helps, but it does not remove the need to budget for gaps.

What long-term care insurance is in Germany

Germany’s Pflegeversicherung is the compulsory long-term care system that sits alongside health insurance. It forms part of the wider framework of social security in Germany, and it exists in both statutory and private compulsory forms.

The key point is that this social long term care insurance Germany system is designed as partial support, not full-cost protection. Official information from the official national health portal of Germany and the Federal Ministry of Health both stress that people may still need to pay some elements of their own costs.

Statutory, private and supplementary cover

Type	What it is	Main point
Statutory cover	Compulsory cover linked to statutory health insurance	Usually attached automatically
Private compulsory cover	Compulsory cover for people in private health insurance	Core benefits are broadly equivalent
Supplementary cover	Optional private top-up insurance	Meant to reduce the remaining gap

Who pays and who can claim benefits?

Employees, employers, pensioners, self-employed residents, students, and families can all be covered by long-term care insurance, but the route depends on health insurance status. The Federal Ministry of Health says contributions are paid by employers and employees in largely equal parts, while private policyholders take out compulsory private care cover through their provider.

The benefits available to policy holders depend on an approved care assessment, an assigned care grade, and minimum insurance history rules.

Who is automatically covered?

• Employees and most people in statutory health insurance are normally covered through the same insurer.
• Dependants may be included through family insurance in some statutory cases.
• People with private health insurance must also have private compulsory long-term care insurance.
• Self-employed residents need to check whether their health insurance route places them in the statutory or private compulsory system.
• If you have just arrived, are privately insured, or are unsure about family cover, ask your insurer to confirm your status in writing.

Who is eligible for benefits?

To qualify, you must be recognised as needing care under the legal rules. That usually means your independence is impaired for health reasons, the situation is expected to last at least six months, and you have been assigned a Pflegegradafter assessment.

To qualify for long-term care benefits in Germany, you must be officially recognized as needing care under current legal regulations. This generally requires that your independence is impaired due to health reasons for a duration expected to last at least six months, and that you have been assigned a specific care grade, or Pflegegrad, following a formal assessment.

Additionally, you must meet the insurance history requirements, which typically stipulate that you have held insurance for at least two years within the last decade, or have been covered under family insurance. When you are ready to proceed, you should apply directly through your insurer’s Pflegekasse or your private provider, ensuring you keep all relevant medical documentation and evidence that illustrates how your daily life is affected. If you are privately insured, it is also advisable to verify any specific exceptions with your insurer, Pflegekasse, or Medicproof.

What does it cover and what will you still pay?

Statutory long-term care insurance can support care at home, professional services, respite arrangements, short-term care, and residential care. This is different from full reimbursement, because support depends on the care grade, the setting, and the benefit type.

Care setting	What insurance can help with	What often stays out of pocket	What to verify
Home care by relatives	Care allowance	Extra support, lost income, household costs	Care grade and allowance rules
Home care by professionals	Care benefits in kind	Costs above the approved amount	Provider charges and benefit limits
Short-term or respite care	Temporary care support	Extra accommodation and related costs	Eligibility and current yearly rules
Residential care	Contribution to care costs	Food, accommodation, investment costs, part of care costs	Full written fee breakdown

Home care, care allowance and support services

• Pflegegeld (care allowance) is cash support when care is organised mainly by relatives or other informal carers.
• Pflegesachleistungen (care benefits in kind) are benefits used for professional home care services.
• Combination benefits let you mix family care and professional services.
• Respite care and short-term care can help when the main carer is unavailable or home care is temporarily not possible.

In practice, this means the system can support both family-led care and professional help, but the amount and type of help change with the care grade. The amount of money available does vary based on changes to government policy – check current yearly amounts before making plans.

Nursing homes and the out-of-pocket gap

Residential care is where many expat families get a shock. Insurance may contribute to the care element, but food, accommodation, investment costs, and part of care costs can still remain with the resident.

This means you should treat insurance support as one part of the funding plan, not the whole plan. Before signing anything, ask the care home and the Pflegekasse for a current written breakdown.

Cost area	Often partly covered?	What to ask
Care costs	Yes	How much depends on care grade and current rules?
Accommodation and meals	Usually no	What is the monthly resident share?
Investment costs	Usually no	Are building or regional charges added?
Extras	Usually no	What services are billed separately?

When supplementary cover may be worth comparing

Optional top-up cover can be worth comparing if you want more protection against future care gaps, especially for home care or nursing home costs. It does not replace compulsory long-term care insurance, and it should be compared carefully against savings, family support, and other priorities. For wider context, see Expatica’s insurance in Germany.

You might decide to consider supplementary cover if:

• You want extra protection against future out-of-pocket costs.
• You would prefer to pay higher premiums rather than relying only on savings when a care need arises.
• You can compare exclusions, waiting periods, and rising premiums carefully.

How do care grades and the application process work?

The process is fairly linear. You apply to the insurer or Pflegekasse, an assessment checks how independent the person is in daily life, a Pflegegrad is assigned, and that decision determines which benefits can be used. If the grade or refusal seems wrong, you can appeal.

How care grades are assessed

A Pflegegrad is the official care grade used in Germany. Assessors look at how much help a person needs to manage daily life, not just at one diagnosis.

They consider areas such as mobility, self-care, cognition and communication, managing illness-related demands, and everyday functioning. Official guidance on care grades makes clear that the same illness can lead to different grades if day-to-day independence differs.

How to apply and prepare for the assessment

1. Contact your statutory insurer’s Pflegekasse or your private provider and state that you want to apply for care benefits.
2. Return the form and choose the broad type of support you expect to need.
3. Gather medical letters, hospital reports, medication lists, and notes showing where daily help is needed.
4. Attend the home assessment and describe an average difficult day, not a rare good day.
5. Read the decision letter carefully, including the assigned care grade and approved benefits.
6. Appeal if the claim is refused or the care grade seems too low.

What expats should check after moving to Germany

Expats often know they need health insurance, but do not realise that long-term care cover usually follows that choice. If you are moving in retirement, read Expatica’s retiring in Germany as well, because insurance route and contribution history can matter later.

The risk here is assuming the system will sort itself out by itself. If you make a claim soon after arrival, insurance history, family insurance status, and whether you’re on a public or private insurance route can all matter.

• Newly arrived employees should confirm that long-term care cover is attached to health insurance from day one.
• Self-employed residents should confirm whether they are in statutory or private compulsory cover.
• Private policyholders should check which provider handles assessment and reimbursement.
• Families should ask whether a spouse or child is co-insured or needs separate cover.
• Anyone with recent residence abroad should ask how the minimum insurance history rule may affect a near-term claim.

Managing care costs across borders

Some expats support a parent in Germany from abroad, pay euro co-payments from another country, or set money aside in euros for future care costs.

If you need to send money to Germany, you can compare Wise international transfers for secure payments which use the mid-market exchange rate with transparent fees. A Wise multi-currency account can also help you hold and manage euros and other currencies between countries.

If cross-border admin is becoming a burden, compare your options before setting up recurring payments or keeping large euro balances with a bank in another country.

Frequently asked questions about long-term care insurance in Germany

Is long-term care insurance mandatory in Germany?

Yes. Long-term care cover is compulsory for people with statutory or private health insurance, and is usually attached to the selected health insurance route. What you can claim later still depends on an approved assessment and the other eligibility rules.

What is Pflegeversicherung in Germany?

Pflegeversicherung means long-term care insurance. It helps with care costs when a person needs long-term support, but it is partial cover rather than full reimbursement, so some costs can still remain with the person receiving care.

How much does long-term care insurance pay in Germany?

The amount depends on the care grade, the care setting, and whether support is paid as cash, services, or residential care contributions. Rates change, so check current yearly figures through gesund.bund’s application guidance or your insurer before making plans.

How do you apply for long-term care benefits in Germany?

You apply through your insurer or Pflegekasse, or through your private provider if you are privately insured. After that, there is an assessment, a care grade decision, and then a benefits decision. If needed, you can appeal.

Do expats need private long-term care insurance in Germany?

Not automatically. Expats do not usually need to choose private compulsory long-term care insurance separately unless their health insurance route requires it. If you are self-employed, privately insured, or newly arrived, verify your exact route directly with your insurer.

Useful resources

• Long-term care insurance overview – Official Health Ministry guide to the compulsory long-term care system
• Care grades guide – Overview of the criteria for care assessments.
• Applying for care benefits – Guidance on submitting your application for benefits.